胶囊内镜在消化系统疾病中的诊断价值

目的：探讨胶囊内镜在消化系统（尤其是小肠）疾病中的诊断价值。 方法: 对北京大学第三医院100例M2A胶囊内镜检查患者进行临床资料分析和电话随访。 结果: 在不明原因消化道出血、腹痛或腹部不适和腹泻患者中，胶囊内镜检查异常病变发现率分别为67.6％、42.9％和44.4％，临床确诊率为60.0％、80.0％和72.2％，胶囊内镜检查准确率为75.0％、92.9％和84.6％；对小肠病变的诊断敏感性为77.3％、87.5％和66.7％，特异性为50.0％、95.0％和90.0％，阳性预测值为94.4％、87.5％和66.7％，阴性预测值为16.7％、95.0％和90.0％。使用甲氧氯普胺（10 mg肌注）组患者的胶囊内镜胃通过时间明显短于未使用组（15.0 min vs 30.5 min，P=0.019）。 结论: 胶囊内镜在诊断小肠疾病方面是一种无创、安全且有效的检查方法，甲氧氯普胺有助于缩短胶囊内镜的胃通过时间。

Evaluation of capsule endoscopy on the diagnosis of gastrointestinal diseases

Objective:To investigate the diagnostic value of capsule endoscopy in patients with gastrointestinal diseases of unknown causes (especially with small intestinal diseases).Methods:The clinical data and images from M2A capsule endoscopy of 100 consecutive patients from 2004 to 2009 in Peking University Third Hospital were analyzed.These patients were followed up by telephone.Results:The patients with metoclopramide (10 mg,intramuscular injection) had a significantly shorter gastric transit time in capsule en...